Clinical Psychology Forum | Volume 1, Issue 373
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Articles in this issue
Articles
Article
The climate crisis – A question of connection
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As clinical psychologists we are aware of the fragility of the self and the power of emotion to overwhelm rationality. As human beings, parents and grandparents, we are aware of the threat that the climate crisis poses to the future of our planet. This knowing is brought together here, and points us towards using our clinical skills in the service of mobilising behaviour change to face up to and mitigate the impending catastrophe.
Article
Building families through MAR (medically assisted reproduction), donor conception and surrogacy: Where does this fit into clinical psychology?
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In the following account, the author reflects on her experiences with individuals and families who have used Medically Assisted Reproduction (MAR) in order to create their families. The article covers some of the history of this constantly developing field, the legislation and regulations in the UK, and some of the inherent complexities. She suggests that Clinical Psychologists need to know more about this area, in order to respond appropriately to those they assess and treat, as in all specialties, issues relating to conception may have a relevance to the issues to be addressed.
Article
Reflections on the NHS lothian psychological wellbeing after Covid-19 group sessions
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Long-Covid symptoms and increased psychological distress have been recognised to have had a significant longterm impact on those who were hospitalised due to Covid-19. To address the needs of this population, the Lothian Mental Health after Covid-19 Hospitalisation (MACH) Service developed and delivered a pilot group intervention which offered psychoeducation and a space to connect with others. The present article seeks to evaluate this group intervention, learning from its successes and challenges to better inform future interventions for this population.
Article
Racialised minority women’s experiences of psychological intervention across perinatal and maternal mental health services
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Policies such as The Perinatal Mental Health Care Pathways document (2018) state mothers and birthing people experiencing psychological difficulties should have timely access to evidence-based psychological therapies. However, psychological distress often goes unidentified in racialised minority women and birthing people who have poorer experiences and outcomes within perinatal contexts compared to White women. Whilst limited research has focused on this within the perinatal period, there is greater recognition concerning how culturally sensitive practices can facilitate equity in care outcomes. This service evaluation aimed to explore racialised minority women’s experiences of psychological intervention within a Perinatal and a Maternal Mental Health Service to evaluate service provision and inform service development. Semi-structured interviews with eight women who accessed psychological intervention were analysed using thematic analysis. Two superordinate themes were constructed, with findings suggesting participants had mostly positive experiences of psychological intervention. Cornerstones of therapeutic engagement comprised six subthemes: empathy, flexibility, the utility of psychological approaches, acknowledging family and community systems, points of difference and cultural context as a ‘spotlight’. This theme encapsulated psychological therapist’s relational and interventional approaches alongside participant preferences which influenced intervention experiences. Therapists were generally experienced as empathic and flexible although some participants desired greater flexibility relating to various practical aspects. Psychological approaches were experienced as beneficial although some wanted greater exploration of childhood trauma and found trauma-focused CBT emotionally demanding. Most participants preferred female therapists due to various socio-cultural reasons and felt systemic factors and their cultural context were acknowledged which enhanced the therapeutic relationship and outcomes where relevant with the inverse also apparent. History repeating itself comprised three subthemes (lack of representation, mistrust of the system and disorientation in help-seeking). This reflected mainly Black participants’ negative healthcare experiences and structural racism. Therapeutic and organisational implications are discussed.
Article
A service evaluation exploring ethnic monitoring in a Specialist Perinatal Mental Health service: Barriers and improvement opportunities
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Ethnicity recording within the NHS is vital to gain understanding of local communities and to shape services appropriately. Health inequalities within perinatal mental health services are evident and have been linked to poor outcomes for mothers. Initial ethnic monitoring audits indicated barriers to ethnicity recording. A staff survey to explore staff attitudes to ethnic monitoring was completed within the service. Data was collected using a survey exploring difficulties and attitudes towards ethnicity monitoring. Results revealed themes including time pressures and discomfort with exploring race and culture. Recommendations to improve ethnicity recording and staff confidence included making changes to service procedures, introducing conversations about difference and diversity into teams and developing resources for staff. The service evaluation highlighted the need for clear and regular ethnicity monitoring reporting within the service. It is essential that services understand the different cultural and contextual factors that might influence patient care and that service users receive a high-quality service regardless of their background.
Article
Learning from reflection – good practice in handover with neurodiverse clients
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This article details the reflection process that arose as a result of our recent experiences with client handover within a national, specialist, adult neurodevelopmental psychology service, following one clinician leaving the service. The departing clinician and the team used this ‘learningfrom experience’ opportunity to collectively reflect on handover with neurodiverse clients, thinking about what went well with the whole process, what could have been done differently and to consider the adaptations that this population may require in order to make handovers as smooth as possible. We have summarised the learning points from these reflections into ‘good practice guidance’ for our own service. Literature on best handover practice is limited, especially with respect to neurodiversity, and given the increasing number of neurodiverse clients accessing local or secondary care services, we are sharing our first-hand experiences in the hope that this may be relevant, helpful and/or stimulate discussion for other services experiencing similar situations.
Article
Service evaluation of reflective parenting groups: What are parents’ perspectives on the usefulness of RP groups in improving parental mentalisation and reflective functioning?
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Family safeguarding services bring together multi-agency professionals to support children and families. The recruitment of clinical psychologists has led to the further development of psychological interventions to support families. Reflective parenting groups are an evidence-based intervention offered in family safeguarding services which aim to enhance parents’ capacity to reflect on and mentalise their own and their child or children’s thoughts, feelings, behaviours and intentions and thus better equip them to develop positive parenting practices and relationships with their children. The importance of evaluating services is recognised as best practice. This service evaluation aims to explore parents’ experiences of reflective parenting (RP) groups and their perceptions of how useful the groups are in improving parental reflective functioning. The study employed a qualitative design and eight parents recruited through opportunistic sampling completed semi-structured interviews. Results were analysed using thematic analysis which yielded four main themes and eight subthemes. The four main themes identified were: (1) Benefits of RP groups, (2) Barriers to engaging in RP groups, (3) Different perspectives on online groups, (4) The importance of including fathers. The findings suggest that the groups are effective in improving parental reflective functioning and parents identified several benefits which are supported by the current literature. The study highlights areas of improvement which could enhance parents’ experiences such as facilitating safe and collaborative spaces for parents to share their experiences, offering in person as well as online groups and actively engaging more fathers in the groups.
Article
Team formulation in a specialist inpatient child and adolescent mental health service: Staff perspectives
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Team formulation refers to the ‘process of facilitating a group of professionals to construct a shared understanding of a service user’s difficulties’ (Johnstone & Dallos, 2013, p. 5). This project was conducted at a specialist inpatient CAMHS service for young people under the age of 13 to understand staff views on the usefulness of team formulation and how it could be further developed. The project also assessed the service’s involvement of young people and their parents/carers in formulations following NHS England’s service specification for tier four CAMHS. The study used a sequential mixed methods design. Quantitative data was collected with a questionnaire and analysed, and then qualitative data was collected through focus groups and analysed using reflective thematic analysis. The results were then integrated through triangulation. A high proportion of the staff team took part in the project. Team formulation was reported as generally helpful by staff, especially in developing a shared team understanding and gathering all the information about a young person in one place. Further, staff reported feeling passionate about team formulation, and that it positively impacted their practice. Staff reported difficulties regarding the meeting dynamics and feeling that it is important to involve young people and families in formulations in a different way. The results of this project have inspired discussions about how team formulation is used in the service.
Article
An evaluation of the Newcastle Model in supporting stress and distress in people with dementia in acute general hospital settings
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This service project evaluated the clinical utility of the Newcastle Model in supporting ‘stress and distress’ in people with dementia in acute general hospital settings. We demonstrated significant reductions in both the perceived severity of stress and distress experiences, and the perceived difficulty for hospital staff in supporting stress and distress experiences. There is a promising role for Newcastle model-led interventions in supporting stress and distress experiences for people with dementia in acute general hospital settings. However, further practice-based evidence is required to demonstrate its full utility within this setting.